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Permit
i r , dr�r,', CITY OF TIGARD ELECTRICAL PERMIT � r � �.: COMMUNITY DEVELOPMENT Permit #: ELC2010 -00224 �T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/06/2010 Parcel: 1 S136CA01500 Jurisdiction: Tigard Site address: 7705 SW PFAFFLE ST Subdivision: Lot: 0 Project: Hawthorne Villa Project Description: (1) branch circuit for fire alarm notification Owner: FEES HAWTHORNE VILLA LTD PARTNERSHIP Q uantity Description Date Amount BY TVHP, 6160 SW MAIN ST BEAVERTON, OR 97005 1 crt Branch Circuits 05/06/2010 $56.18 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 05/06/2010 $6.74 Electrical Contractor: STONER ELECTRIC 1904 SE OCHOCO MILWAUKIE, OR 97222 PHONE: 503 - 462 -6500 FAX: 503 - 659 -4968 Type of Use: MF Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: el /l `i Permittee Signature: - 11 , ‘'k c / p AT OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. May. 5, 2010 1 :00PM � ��.11 aq ttay No.2575 �y n{ P. 1 o NiN -4. F u . i i i , 'F ,�." ' g t Electrical Permit AD1 lication t 1 » , t ,1 (l I ,�l I� ''� 1 ' � ' q ua' ie , .A n � 'st'Ss all:,M:.* rirarw,Ia ii 7 4. tie 14 s 7.4 , a t ,L C of Tigard I " ` C 11 � R lkrarit • No.. lig k 1 13125 SW HallIllvd.,Tigard,OR97223 Plan � �� ✓•;1 ` I�f � 1 II _ Other Permit: Phone: 501639.4171 Fax: 503.598.196M Ay DataB °- AN() • r; r Inspection Line: 503 "639 "4175 DateRca 1n i . B SesPage2for �iay.3', =,.to/ Internet: www.ligard -or,gov • Notdiied/Metwd: is SupptementalInformation Y Y. aj . , . TYPR OIr I dr � PLAN REVIEW 1 �• '""�= ••�L'' f SION Please chock elf dace apply (submit2 sets of prance w /items chocked behav): ❑ Now construction ddition/alteration/rcpincemen ❑ Service or feeder 400 amps or more 17/Building over three aeries. ❑ Demolition ❑ Other. where available fault current ['Marinas andtxntyards - CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use egiciatural ❑ I- and 2- family dwelling �'C ommereial/indusirial ❑ Accessory building amps for all other installations buildings. f Multi - family ❑ Master builder ❑ Other. [Wile pump ['Installation of75KVA or JOB SITE INFORMATION AND LOCATION' ❑ Emergency ofne em' mraersapatate1y aystaa. [] Addition ofnew motor load o( ❑ "A °, 11". «1.2' "1-3 Job no /0 V 1 Job site eddross: 77 © 5 /./�n,r 10010? ammo. y ❑ Six or more res un ❑ Recreational vehicle parks. City /State/Z1P p- 9 7Z. ❑ � �ro fxihuca ❑ 600 voice Suite/bldg./apt.no.: r Project name: Ice more don . � ❑Haaardouslocations ll y 7 . �,� �Ll�/ ❑&Keineorfeeder600ampsormore. FEE SCHEDULE Cross Street/directions to job site: ne,r.tatbn 1 Qty. 1 Pea 1 Totat 1 • i New residential single- or multi - family dwelling unit. Indudea attached garage. , Subdivision: I Lot no.: 1,000 eq. ft, or leas 168.54 4 Tax map/parcel no.: Ea. addl 500 sq. A. or portion 33.92 1 Limited energy, residential 67.84 2 DESCRIPTION OF WORE (with above so. ft) , �f� Limited energy, mu lti- famity LIJ1 �,� ,e �a�''" .�4,¢L. /,d- �VprF+c.+4rrort/ residential above sq. ft) 67.84 2 Services or feeders installation alteralion, and /or relocation 200 amps or less I 100.70 _ 2 ❑ PROPERTY OWNER 1 D TENANT 701 amps to 400 amps 133.56 2 Nome: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 - City /State/ZIP: Temporary services ar feeders inatatlalion, alteration, and /or . relocation Phone: ( ) I Fax; ( ) 200 ampa or leaa - 59.36 1 Owner Installation: This installation is being made on property that I own which i9 not 201 ampa to 400 amps 125 "08 2 intended for salo, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 ' 2 Owner signature: Date: Branch circuits -new, alteration, or ertenslon, er panel A.Fee for branch circuits with ❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: 11 Feefor branch circuits Contact name: without aerviceor feeder fee, / 56.18 /f( 2 first branch circuit Address: Each add'l branch circuit 7 "42 2 -- MIseellaneoua (service or feeder not Included) City/State/ZIP: Each manufactured or modular dwell" 67.84 2 Phone: ( ) p ( ) dwelling, Reconnect only 67.84 2 E Pump or irrigation circle 67.84 2 CONTRACTOR Sign outline lighting 67.94 2 Busincss name : STONER ELECTRIC, INC. energ p nel, a e rhmde or energy panel, alteraton, or Address' 1904 SE OCHOCO oxlenaioaDescribe: Page2 2 City /StatelZ1P: MILWAUKIE, OREGON 97222 Each additional inspection over allowable In an of the above Per inspection 66.25 Phone: ( 503) 462 -6500 Pax' (503) 659 -4968 Investigation per hour (1 hrmin) 66,25 - CCB ' 44623 Electrical Lic.: 26 -122C Suprv. Lk: 3496S Indualri aI plant per hour t I 78.18 p1.ie, ^C i . '".'� PERMIT Subtotal! gl FrrR1cAL Suprv. Electrician signature, requited: F I� ' B� ' Print name: MICHAEL FALCONER Date: g/,5� ,eo Plan review (25%ofpcnntlfoc): _- State surcharge (12% of permit fee): (, ,7 5 Authorized signature: TOTAL PERMIT FEE: 6 Z, 9 Print name: Date: Thu p ermit application expires if a penult Is not obtained titian 180 days after It bat been accepted as complete. • Number of inspections allowed per pamit. 1 :42011dlegVrnnial5L4namitagp.deo 10/01 /09 44046t5T(1L 5Ic0Mhvae